Association Between Anterior Laryngeal Microweb and Vocal Fold Nodules: A Case-Control Study

This study aimed to determine whether congenital anterior laryngeal microweb is associated with vocal fold nodules (VFN), and to assess its prevalence in patients diagnosed with VFN and the coexistence of multiple minor structural alterations of the vocal cords (MSAs) as described by Paulo Pontes.

A retrospective case-control study was conducted in patients evaluated between 2012 and 2024. A total of 99 patients with VFN were included in the case group. A total of 649 were included in the control group, described as patients without VFN. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.

The prevalence of microweb was 16% (16/99) in cases and 5% (36/649) in controls. After adjusting for sex, age at diagnosis, smoking status, coexistence of other minor laryngeal alterations, asthma, rhinitis, gastroesophageal reflux, and professional voice use, an association was observed (OR 4.14; 95% CI 1.82-9.39) between a history of laryngeal microweb and the development of VFN. Among the 96 patients with MSAs, 11 (11%) presented more than one alteration.

This is the first study to attempt to control for potential confounding through a case-control design, confirming the association between anterior laryngeal microweb and VFN.